SCN5A Variant D310N Detail

We estimate the penetrance of LQTS for SCN5A D310N around 6% and the Brugada syndrome penetrance around 15%. SCN5A D310N was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D310N is present in 1 alleles in gnomAD. D310N has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A D310N around 6% (0/11) and the Brugada syndrome penetrance around 15% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.29 0.684 2.6 0.319 20 0
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance Density is our previously published method to calculate the average BrS/LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT3 BrS1 Other Other Disease
LITERATURE, COHORT, AND GNOMAD: - 1 1 0 0 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

D310N has 31 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
295 15 E295K,
296 14
297 14
298 13 G298D, G298S,
299 13 L299M, L299F,
300 12 V300I,
301 11
302 11
303 10
304 9
305 8 D305N,
306 8 L306F, L306V,
307 7
308 5
309 4 S309N, S309C,
310 0 D310N,
311 4
312 5 c.934+1G>A, E312K, c.934+4C>T,
313 7
314 8
315 8 L315P,
316 9
317 10 K317E, K317M, K317N,
318 11
319 11 G319R, G319S, G319C,
320 12 T320N,
321 13 S321Y,
322 13
323 14
324 14
325 15 L325R,